Cracked: The Unhappy Truth About Psychiatry, by James Davies, PhD: Book Review

This is an excellent book, published by Pegasus Books earlier this year. The cover blurb says that it is “…scathing about every aspect of psychiatry.”

Dr. Davies, who is a practicing therapist in the UK, brings to the subject enormous energy and enthusiasm. He has interviewed Robert Spitzer, Allen Frances, Irving Kirsch, Joanna Moncrieff, Sami Tamimi, Peter Breggin, and many, many others.

Some of the points he makes will be familiar to those of us on this side of the debate, but there is an enormous amount of fresh material and insights. The book careens, almost literally, from one psychiatric outrage to the next, and the arguments are supported by appropriate citations.

A particularly refreshing aspect of this work is the inclusion of a great deal of input from clients.

Here are some quotes:

“Why has psychiatry become the fastest-growing medical specialism when it still has the poorest curative success? Why are psychiatric drugs now more widely prescribed than almost any other medical drugs in history, despite their dubious efficacy? And why does psychiatry, without solid scientific justification, keep expanding the number of mental disorders it believes to exist – from 106 in 1952 to 374 today? What is going on?” (p x)

“And yet, as we have seen, there are forms of medicalization that are clearly unhelpful. These are the forms that invasively spread medical authority where it was never designed to go. For instance, ‘problems’ such as low achievement, certain kinds of truancy, or underperformance have attracted medical diagnoses and intervention in our children, as have many normal reactions to the demands of adult life that are labeled as so-called ‘stress disorders’ to be biologically explained and pharmacologically treated.” (p 33)

“An early experiment published in the Lancet explored this very question. What the group of researchers did was gather up fifty-six medical students and hand each of them a package containing red and blue pills. All the students were told was that one color represented a tranquilizer and the other a stimulant. After taking the pills, the students were then asked which set of pills were the stimulants and which the tranquilizers. The majority concluded that the blue pills were the tranquilizers and the red pills the stimulants. They reached this conclusion because when taking the blue pills they felt far less alert and much drowsier than when taking the red pills. The researchers then told the students that, chemically, the blue and red pills were exactly the same – both sets of pills were made entirely of sugar.” (p 67)

“So the real question we must ask is not whether pills are leading people to change their lives, but whether they are leading people to change them in the way that is natural to them. Are these manufactured states of mind guiding people to make the right moves or decisions? Or are they stacking up more problems for them in the future, like many other mood-altering substances can do? Is it right that pills should make us feel suddenly invincible, or blasé about our son’s cancer, or sexually unbridled, or indifferent to staying in a dead-end job? Is it right that they should suddenly dry up our grief for someone we love?” (p 91-92)

“It appears that when companies research their own products, one way or another they get – or perhaps simply choose to publish – results from which the company stands to benefit. The financial rewards of moving the goalposts, it seems, makes the temptation of doing so perhaps too strong to resist.” (p 129)

“While many doctors are savvy about the cozening claims of ‘pharma fraudulence,’ the evidence is that they still have a significant impact on doctors’ prescribing habits as well as expanding the antidepressant market.” (p 167)

“The categories of mental disorder (rather than painful experiences themselves) are psychiatric constructions and not scientifically discovered biological entities. As these categories have greatly proliferated in number in the DSM and ICD, psychiatry has reclassified more and more of our natural human behaviors and feelings as psychiatric disorders requiring treatment. By doing so, psychiatry has not only expanded its jurisdiction over more of us (one in four of us apparently now suffers from a mental disorder) but has also, by inflating the number of mental disorders, created a huge market for psychiatric treatments.” (p 171-172)

“Many psychiatrists’ claims are no more substantiated than are the claims of religion. This is because, in so many areas that they survey, psychiatrists do not prove things but decide things: they decide what is disordered and what is not, decide where to draw the threshold between normality and abnormality, decide that biological causes and treatments are most critical in understanding and managing emotional distress.” (p 181)

I strongly recommend this book.

Disclosure: I have no financial interest in this work, or in any of the books/articles that I mention on this website.

About Phil Hickey

I am a licensed psychologist, presently retired. I have worked in clinical and managerial positions in the mental health, corrections, and addictions fields in the United States and England. My wife Nancy and I have been married since 1970 and have four grown children.

The phrase "mental health" as used in the name of this website is simply a term of convenience. It specifically does not imply that the human problems embraced by this term are illnesses, or that their absence constitutes health. Indeed, the fundamental tenet of this site is that there are no mental illnesses, and that conceptualizing human problems in this way is spurious, destructive, disempowering, and stigmatizing.

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The purpose of this website is to provide a forum where current practices and ideas in the mental health field can be critically examined and discussed. It is not possible in this kind of context to provide psychological help or advice to individuals who may read this site, and nothing written here should be construed in this manner. Readers seeking psychological help should consult a qualified practitioner in their own local area. They should explain their concerns to this person and develop a trusting working relationship. It is only in a one-to-one relationship of this kind that specific advice should be given or taken.